An atypical form of a typical pathology: A report of a combined lesion

Abstract

Aggressive periodontitis, refers to a multifactorial, severe, and rapidly progressing form of periodontitis. Gingival fibromatosis is a heterogenous group of enlargement characterized by progressive increase in submucosal connective tissue elements. Here we present an atypical case report of a 13 year old male patient who presented with severe, bilateral gingival enlargement along with aggressive periodontitis around first molars bilaterally. Careful recording of the case history and results of clinical examination, laboratory blood analysis, radiological findings, and microbiological and histopathological investigations were noted and a critical review of similar conditions was taken into account to arrive at the said diagnosis. Treatment consisted of extraction of teeth with hopeless prognosis, modified widman flap procedure in maxillary arch, gingivectomy in mandibular arch as well as supportive use of antibiotics and an interdisciplinary approach to restore the teeth functionally. After a follow-up period of 2 years, the patient’s periodontal status remains healthy with no recurrence of gingival enlargement, facilitating the eruption of permanent teeth.